title: Terbutaline in myasthenia gravis: a pilot study.
abstract: The objective of this study was to assess the short-term efficacy and safety of terbutaline, a beta2-adrenergic agonist, in patients with myasthenia gravis (MG) in a randomized, double-blind, placebo-controlled, crossover study. The primary endpoint for efficacy was a reduction of at least 3 points in the quantitative MG score (QMGS). Secondary endpoints included changes in the functional disability scale (FDS), forced vital capacity (FVC), grip strength, anti-acetylcholine receptor (AChR) antibody levels and decremental response. During the terbutaline phase, five of eight (63%) patients had an improvement in the QMGS of 3.0 or greater, while 3/8 (38%) patients had improvement in the FDS of one grade. No improvement was seen during the placebo period. Statistical analysis using Wilcoxon signed-rank test confirmed that terbutaline treatment resulted in a significant improvement in QMGS. There was no change in FVC, grip strength or anti-AChR antibody levels, but there was an improvement in the decremental response during terbutaline phase. Terbutaline was well-tolerated in all study subjects. We conclude that terbutaline may be an effective adjunct therapy in a subset of patients with myasthenia, although confirmation with larger trials will be required.
authors.affiliation: Department of Neurology, and the Brain Research Institute, The University of Chicago, Chicago, IL 60637, USA. bsoliven@neurology.bsd.uchicago.edu
authors.forename: Betty
authors.initials: B
authors.lastname: Soliven
authors.forename: Kourosh
authors.initials: K
authors.lastname: Rezania
authors.forename: Betul
authors.initials: B
authors.lastname: Gundogdu
authors.forename: Barbara
authors.initials: B
authors.lastname: Harding-Clay
authors.forename: Joel
authors.initials: J
authors.lastname: Oger
authors.forename: Barry G W
authors.initials: BG
authors.lastname: Arnason
mesh_terms: D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy*; D010865:Pilot Projects; D010919:Placebos; D011729:Pyridostigmine Bromide / Q000008:administration & dosage; D013726:Terbutaline / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000318:Adrenergic beta-Agonists; D002800:Cholinesterase Inhibitors; D007166:Immunosuppressive Agents; D010919:Placebos; D011729:Pyridostigmine Bromide; D013726:Terbutaline